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General NPI Number Information
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NPI Number | 1700052057
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Entity Type | Organization
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Legal Business Name | DEBORAH E HEALEY MD PLC
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 100 EAST SOUTH STREET SUITE 2
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5217
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Country | US
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Telephone | 434-298-0456
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Fax |
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Provider Business Mailing Address
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Address Line | 100 EAST SOUTH STREET SUITE 2
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5217
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Country | US
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Telephone | 434-298-0456
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Fax |
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Authorized Official
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Title or Position | OWNER MANAGER & SOLO PRACTITIONER
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Name | DR. DEBORAH ELIZABETH HEALEY
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Credential | MD
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Telephone | 434-296-0456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101038681
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License Number State | VA
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